Injury rates and patterns in professional American rugby: a prospective observational study

Background: As American rugby becomes increasingly popular, an understanding of injury rates and patterns is essential for injury prevention, management, and player safety initiatives. We evaluated the injury characteristics and associated time loss sustained at the professional rugby level in the United States over one season. Methods: One professional rugby team was followed, and all injury data were prospectively collected over 13 consecutive weeks, with eight games during this period. Player involvement in games and practices was recorded by a licensed medical professional. For each described injury event, the timing, body area injured, and time lost from the sport caused by the injury were recorded. The Mid-P exact test was utilized to calculate injury rates with 95% confidence intervals as well as an injury rate ratio (IRR) to quantify differences in injury rates. Results: A total of 49 injuries over 2,456 athletic exposures (AEs) were included in our 13-week study period of one professional rugby season, with an overall injury rate of 19.95/1000 AEs. IRR between games versus practice was 5.21. Overall, 43% of the injuries occurred in the lower extremities and 18% in upper extremities, and there was a 12% incidence of concussion. Average time lost from sport was increased for game-related injuries (8.2 days) and concussion (7.8 days); however, severe injuries occurred more often in the lower extremity (n=4). Conclusions: The overall injury rates in this study correspond with previous amateur and international rugby literature showing a trend toward increased injury risk during gameplay at a professional level.